恶性黑色素瘤是一种组织内含有黑色素为特征的高度恶性肿瘤,好发于皮肤,原发于胃肠道的甚少。现报告胃恶性黑色素瘤1例,并结合文献加以讨论。 1 病历报告女性,60岁。反复上腹部疼痛10余年,疼痛可自行缓解,与季节、饮食无关。偶有恶心、呕吐、返酸、嗳气。1982～1990年期间曾行3次胃镜检查,均示胃角及十二指肠球部溃疡疤痕。活检病理报告均为炎症伴中度肠化,不典型增生。近1周来疼痛加重,复查胃镜示胃窦前壁大片增生性病变,高低不平,表面覆盖坏死渗出物,质硬易出血。活检病理报告为炎症坏死组织渗出物,局灶区域见低分化腺癌。拟诊为胃癌,于1991 Malignant melanoma is a highly malignant tumor characterized by the presence of melanin pigments in the tissue. It occurs predominantly in the skin and is rarely found in the gastrointestinal tract. Gastric malignant melanoma is reported in 1 case and is discussed in the literature. 1 Case Report Female, 60 years old. Repeated upper abdominal pain for more than 10 years, the pain can relieve itself, has nothing to do with the season, diet. Occasional nausea, vomiting, acid reflux, belching. During the period from 1982 to 1990, three gastroscopy examinations were performed and all of them showed scars on the gastric horn and duodenal ulcer. The biopsy pathology reports were inflammation with moderate intestinal metaplasia and dysplasia. In the past 1 week, the pain increased, and the gastroscope showed a large proliferative lesion in the anterior antral wall, which was uneven and covered with necrotic exudates. Biopsy pathology reports exudative tissue in inflammation and necrosis, and poorly differentiated adenocarcinoma in the focal region. Expected diagnosis of gastric cancer, 1991